Leave Request for Hourly (Non-Exempt) Employees

PERSONAL INFORMATION
DATES/HOURS OF LEAVE—Recorded in 15 minute increments



LEAVE TYPE

Choose multiple leave types


Choose just one leave type

REASON
SUPERVISOR
Department TIMEKEEPER

Signatures only required if printing request instead of submitting online.




*Other Leave--Disaster Leave-DIS, Donor Leave-DON, etc.

Is this Family Medical Leave Act related? If yes, refer to the FMLA information under Leave Programs